92 Decision Citation: BVA 92-15173
Y92
BOARD OF VETERANS' APPEALS
WASHINGTON, D.C. 20420
DOCKET NO. 92-00 218 ) DATE
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THE ISSUE
Entitlement to service connection for right hip and acquired
psychiatric disorders.
REPRESENTATION
Appellant represented by: AMVETS
WITNESS AT HEARING ON APPEAL
Appellant
ATTORNEY FOR THE BOARD
Brian J. Milmoe, Counsel
INTRODUCTION
This matter came before the Board of Veterans' Appeals (BVA)
on appeal from a rating decision entered in 1991 by the
Detroit, Michigan, regional office (RO). The veteran served
on active duty from December 1951 to September 1953. A
notice of disagreement was received by the RO in May 1991.
The veteran was afforded a hearing before the hearing
officer at the RO in July 1991, and in November 1991, the
hearing officer issued a decision in which the benefits
sought continued to be denied. A statement of the case was
provided to the veteran in November 1991. Received by the
Department of Veterans Affairs (VA) in January 1992 was the
veteran's substantive appeal. Entered into the record in
February 1992 was a Statement of Accredited Representative
in Appealed Case. The case was received and docketed at BVA
in February 1992, following which the veteran's claims
folder was referred to his representative, AMVETS, for
review. That organization submitted additional written
argument to BVA in March 1992. The case is now ready for
appellate review.
CONTENTIONS OF APPELLANT ON APPEAL
It is contended by the veteran, in substance, that a
preexisting right hip disorder was aggravated by service and
an acquired psychiatric disorder originated during his
period of active duty. With respect to the right hip, the
veteran reports that he sustained a sports-related injury to
the right hip prior to his entrance onto active duty, but he
alleges that he sustained further injury to the right hip in
service when lifting a truck tire. A significant period of
treatment followed, to include hospitalization, for
management of his right hip complaints. Regarding the
psychiatric disorder, the veteran reports that he
experienced undue stress while on active duty, the most
prominent occasion of which involved his riding on a medivac
plane in which he observed wounded soldiers and their
bandages.
DECISION OF THE BOARD
For the reasons and bases hereinafter set forth, it is the
decision of BVA that the preponderance of the evidence is
against the veteran's claim for entitlement to service
connection for a right hip or acquired psychiatric
disorder.
FINDINGS OF FACT
1. All relevant evidence necessary for an equitable
disposition of the veteran's appeal has been obtained by the
RO.
2. Findings involving an acquired psychiatric disorder were
not identified in medical records compiled in service or
during post service years; the existence of an acquired
psychiatric disorder is not objectively shown.
3. A medical examination at service entrance was negative
for evidence of a right hip disorder; the veteran's right
hip disorder unequivocally existed prior to service, based
on his own admission of a sports-related injury involving
the right hip at the age of 13 years and the close proximity
in time of the veteran's complaints of right hip discomfort
to his entrance onto active duty.
4. Service medical records do not indicate that the veteran
sustained any injury to the right hip in service and it is
not otherwise shown that there was an increase in severity
of the preexisting right hip disorder while the veteran
remained on active duty.
CONCLUSIONS OF LAW
1. A right hip disorder clearly and unmistakably preexisted
service and was not aggravated thereby. 38 U.S.C. §§ 1110,
1111, 1153, 5107; 38 C.F.R. §§ 3.303(a), 3.306(b).
2. An acquired psychiatric disorder was not incurred in or
aggravated by service. 38 U.S.C. §§ 1110, 5107; 38 C.F.R.
§ 3.303(a).
REASONS AND BASES FOR FINDINGS AND CONCLUSIONS
At the outset, we find that the veteran's claim for multiple
benefits is "well-grounded" within the meaning of 38 U.S.C.
§ 5107(a). That is, we hold that he has presented a claim
which is plausible. As well, we are satisfied, following a
review of the record, that all relevant facts have been
properly developed and that no useful purpose would be
served by remanding the case to the RO for additional
action. It is of note that, during the course of the
hearing conducted in July 1991, the veteran reported that he
had attempted to obtain medical records from various
treatment providers, but was unable to do so for various
reasons, including death or relocation of the providers.
Efforts are also noted to have been made by VA to secure
medical records from private treating physicians, but those
individuals failed to respond. Accordingly, VA is found to
have no further obligation to assist the veteran with
respect to development of facts pertinent to this claim.
38 U.S.C. § 5107(a).
Service connection connotes many factors, but basically it
means that the facts, shown by the evidence, establish that
a particular injury or disease resulting in disability was
incurred coincident with service, or if preexisting such
service, was aggravated therein. 38 U.S.C. § 1110;
38 C.F.R. § 3.303(a). A veteran who served during a period
of war is presumed in sound condition except for defects
noted when examined and accepted for service. Clear and
unmistakable evidence that the disability manifested in
service existed before service will rebut the presumption.
38 U.S.C. § 1111. Clear and unmistakable evidence is also
required to rebut the presumption of aggravation where the
preservice disability underwent an increase in severity
during wartime service. 38 U.S.C. § 1153; 38 C.F.R.
§ 3.306(b).
I. Right Hip
Preinduction medical examinations performed in March and
December 1951 identify no abnormality of the veteran's right
hip, and, as such, he is entitled to a presumption of
soundness with respect to that disorder. 38 U.S.C. § 1111.
Approximately 19 days following the veteran's entrance onto
active duty, he complained of right hip discomfort after
marching. X-ray films in January 1952 were noted to reveal
a slipped femoral epiphysis. It was during January 1952
that the veteran reported that his right hip had been
knocked out-of-place when playing baseball at about age 13.
He continued to be followed for right hip complaints through
March 1952. No further complaints or findings with respect
to the right hip were set forth in service medical records
until October 1952. Medical records compiled, beginning in
October 1952, indicate the veteran sustained a
sports-related injury, possibly even a fracture, of the
right hip at the age of 13 years and that he had been
assisted by a "bone doctor" for treatment of that injury.
Reportedly, there had been a recurrence of right hip pain
9 years prior to October 1952, with there being a
progressive increase in right hip symptoms over the previous
9 months. No report of any significant recent injury
involving the right hip was made by the veteran. Initial
radiographs were felt to be consistent with old aseptic
necrosis of the head of the right femur, but later X-rays
revealed only a marked coxa vara deformity involving the
right femoral head and neck, which was attributed to an old
fracture, as opposed to osteochondritis. Clinical
examination at that time showed that the right greater
trochanter was abnormally higher than the pelvis, and in
addition, there were moderate tenderness, some limitation of
motion, a slight spasm, a 1.5-inch shortening of the right
leg, and 1/2-inch atrophy of the calf. The opinion of
service department medical personnel was that the coxa vara
deformity of the veteran's right hip was congenital in
nature.
Following the veteran's receipt of inservice medical
treatment on an inpatient basis in October 1952 for
management of his right hip disorder, additional complaints
or findings with respect to the right hip dysfunction are
not identified in subsequently compiled service medical
records, to include the report of a separation medical
examination in September 1953. Testimony offered by the
veteran at the hearing in 1991 was to the effect that he had
been assigned to light duty subsequent to the inservice
hospitalization in October 1952, but data confirming that
allegation are not on file. Even if that were the case,
the absence of any abnormality of the right hip on the
separation medical examination in September 1953 would
indicate that the symptomatology which led to the
hospitalization in October 1952 was but an acute
exacerbation which resolved in relatively short order. As
well, medical data developed during post service years do
not indicate that medical assistance was received earlier
than 1988 for right hip complaints. The lapse of so many
years without a showing of chronic right hip symptomatology
further supports our conclusion that the acute symptoms
identified in service were not productive of any increase in
severity of the preexisting hip disorder. Notwithstanding
the veteran's contentions to the contrary, which we find to
be unsupported by the record, it is our holding that the
veteran's preexisting right hip disorder was not aggravated
by service. 38 U.S.C. §§ 1110, 1153, 5107(b); 38 C.F.R.
§§ 3.303(a), 3.306(b).
II. Acquired Psychiatric Disorder
Service medical records of the veteran are wholly negative
for complaints or findings involving an acquired psychiatric
disorder. Likewise, all medical data compiled during post
service years identify no abnormality consistent with the
presence of an acquired psychiatric disorder. The veteran
at his hearing in July 1991 reported that he experienced
inservice stress, specifically being on a medivac plane on
which he viewed wounded soldiers with bandages. However, he
also stated that he was not treated in service or during
post service years for any psychiatric complaint. His
enlistment record shows no badges or citations reflecting
combat duty during a tour of duty in Korea. While it is not
confirmed that the veteran experienced stress of any kind
while on active duty, the fact that he did not seek medical
assistance either in service or thereafter for
stress-related complaints indicates, in our view, that any
stressful experiences in service were not of such severity
as to produce impairment of the veteran's mental status. It
is undisputed that the veteran is without a current or
former diagnosis of psychiatric disability. For the reasons
noted, we conclude that a grant of service connection for a
claimed acquired psychiatric disorder is not warranted.
38 U.S.C. §§ 1110, 5107(b); 38 C.F.R. § 3.303(a).
ORDER
Service connection for right hip and acquired psychiatric
disorders is denied.
BOARD OF VETERANS' APPEALS
WASHINGTON, D.C. 20420
NANCY R. ROBIN B. KANNEE
ALBERT D. TUTERA
NOTICE OF APPELLATE RIGHTS: Under 38 U.S.C. § 7266 (1992),
a decision of the Board of Veterans' Appeals granting less
than the complete benefit, or benefits, sought on appeal is
appealable to the United States Court of Veterans Appeals
within 120 days from the date of mailing of notice of the
decision, provided that a Notice of Disagreement concerning
an issue which was before the Board was filed with the
agency of original jurisdiction on or after November 18,
1988. Veterans' Judicial Review Act, Pub. L. No. 100-687,
§ 402 (1988). The date which appears on the face of this
decision constitutes the date of mailing and the copy of
this decision which you have received is your notice of the
action taken on your appeal by the Board of Veterans'
Appeals.